Antimicrobial resistance (AMR) could have significant effects on a range of SDGs, according to guidance published by the World Health Organization (WHO). AMR is when bacteria, viruses, fungi, and parasites no longer respond to medicines effectively, making it harder to treat infection and increasing the risk of disease spread, severe illness and death. The publication makes recommendations for UN country teams to address this interlinked threat through the UN Sustainable Development Cooperation Framework.

AMR could push 28.3 million people could be pushed into extreme poverty by 2050 due to high costs of treatment and chronic infections.

The advocacy brief released in October 2021 notes that the 2030 Agenda contains two indicators on AMR, as part of SDG 3 (good health and wellbeing):

• SDG indicator 3.d.2, Percentage of bloodstream infections due to selected antimicrobial-resistant organisms; and
• SDG indicator 3.d.3, Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis (where antibiotics will be disaggregated from the core set of data used in the metadata).

The authors highlight AMR’s broad effects on SDG 3, including that as AMR increases treatment costs, universal health coverage will be unattainable for many countries. In addition, reducing child and infant mortality relies on effective antibiotics. Each year, 200,000 newborns die each year from drug-resistant infections.

Beyond Goal 3, AMR is central to several other SDGs. For example, on SDG 1 (no poverty), AMR could cause an additional 28.3 million people to be pushed into extreme poverty by 2050 due to high costs of treatment and chronic infections. On SDG 2 (zero hunger), animals harmed by AMR affects farmers’ livelihood and broader food security. On SDG 8 (decent work and economic growth), as AMR increases mortality and morbidity, labor supply will decline and could cause a decrease of 1-3% in global economic output by 2030, amounting to losses up to USD 3.4 trillion.

Given all of these interlinkages, the guidance notes the need for coordinated action among UN and national actors to tackle AMR. The authors suggest that the One Health approach should be applied; this refers to a “collaborative, multisectoral, and transdisciplinary approach that recognizes the interconnections between people, animals, plants and their shared environment.”

The authors also call for including AMR in the UN Sustainable Development Cooperation Framework, which is the agreement between the UN and each host government where the UN has a country team. The Cooperation Framework identifies the country’s development priorities and how the UN system is contributing to them. The AMR guidance argues that Cooperation Frameworks can underline the urgency of addressing AMR by noting the linkages with broader development issues, including pandemic preparedness, universal health coverage, sustainable food systems, and the environment. Where the Cooperation Framework lists outcomes on such issues, they should include concrete AMR outputs for improved data, coordination, regulation, or prevention. The guidance also recommends that AMR be mainstreamed into national development plans.

The guidance document was prepared by the three organizations that form the “Tripartite” on AMR: the Food and Agriculture Organization of the UN (FAO), the World Organisation for Animal Health (OIE), and the World Health Organization (WHO), as well as the UN Environment Programme (UNEP) under the coordination of the Tripartite Joint Secretariat on AMR. [Publication: Antimicrobial resistance and the United Nations sustainable development cooperation framework: guidance for United Nations country teams]